Published online Mar 18, 2015. doi: 10.5312/wjo.v6.i2.278
Peer-review started: February 13, 2014
First decision: March 26, 2014
Revised: April 10, 2014
Accepted: September 6, 2014
Article in press: September 10, 2014
Published online: March 18, 2015
The management of rheumatoid arthritis (RA) in the past three decades has undergone a paradigm shift from symptomatic relief to a “treat-to-target” approach. This has been possible through use of various conventional and biologic disease modifying anti-rheumatic drugs (DMARDs) which target disease pathogenesis at a molecular level. Cost and infection risk preclude regular use of biologics in resource-constrained settings. In the recent years, evidence has emerged that combination therapy with conventional DMARDs is not inferior to biologics in the management of RA and is a feasible cost-effective option.
Core tip: In developing world cost of treatment remains a major concern. Recent evidences are emerging that support the equal efficacy of conventional disease modifying anti-rheumatic drugs (DMARDs) as compared to biological DMARDs. In this review we have presented evidences supporting conventional DMARDs in management of rheumatoid arthritis.